Perspectives in Managed Care Pharmacy

[M7] Strategies for Staying Ahead of Specialty Drug Trends: Focus on the Medical Pharmacy Benefit

ACPE UAN: 0233-0000-19-049-L04-P | Contact Hours: 1.25 | Activity Type: Knowledge-based

Faculty(s)

• 

  Eric McKinley, PharmD

  Director of Medical Pharmacy Strategy
  Magellan Rx
  Brandon, Mississippi
• 

  Carly Rodriguez, PharmD

  Pharmacy Director, Clinical Innovation
  Moda Health
  Portland, Oregon

Moderator(s)

• GK

  Grant Knowles, PharmD, CSP

  Vice President, Business Development & Industry Relations
  Ardon Health
  Portland, Oregon

For the tenth consecutive year, specialty pharmaceutical growth has far exceeded that of traditional drugs. Given the large number of specialty products in the pipeline, it is expected this trend will continue for years to come and will continue to challenge managed care organizations.

This challenge underscores the need for care teams to develop and share strategies that allow them to stay ahead of the drug spending trends while ensuring optimal patient care and outcomes. A big focus for the future will be on the drug spend related to the medical pharmacy benefit.

This session will highlight the current trend drivers for specialty drugs on the medical pharmacy benefit and the tactics managed care organizations are using to impact the medical pharmacy benefit. This session will use real-world case studies and outcomes to demonstrate these tactics.

Learning Objectives:

At the completion of this activity, participants should be able to:

1. Summarize trend drivers for specialty drugs covered through the medical pharmacy benefit.
2. Identify the key challenges among managed care organizations related to medical pharmacy benefit management.
3. Describe valuable medical benefit management tactics across lines of business, sites of service, drug therapeutic classes and member benefit design.
4. Explain medical benefit drug management and site of service solutions through novel program development, benefit design, place of service management and utilization management.